Authorization Specialist Job at Cooper Green

Cooper Green Birmingham, AL 35233

Authorization Specialist
    Job ID: 13108
    Functional Area: Health/Medical
    Position Type: Full Time
    Experience Required: Less than 1 year
    Location: Birmingham, AL
    Department: ACC-Patient Access
    Education Required: High School Diploma or GED
    Relocation Provided: No


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Position Description:
GENERAL SUMMARY

Under minimal supervision and according to CGMHSA established policies and procedures, provides a variety of specialized services in support of the operations of scheduling personnel and processes within the multiple clinic settings at Cooper Green. This role will comprise of a mix of traditional authorization specialist duties and insurance verification duties. The Authorization Specialist duties may include the assignments of daily reports, handling and troubleshooting day to day issues authorization specialist face, liaising specialty clinics and primary care providers, schedules referrals internally and externally, issue authorization number for services when appropriate, handles verification and precertification’s for insurance benefits and communicate with patients about patient specific referrals. Consistently demonstrates outstanding customer service to CGMHSA patients, visitors, physicians, and staff.

This is a full time role at 40 hours a week. The schedule is Monday through Friday - 8AM to 4:30PM.

KEY RESPONSIBILITIES
1. Obtains and/or verifies patient demographic & insurance information, and updates appointment status in NextGen per NextGen standards.
2. Schedule patient referrals internally and externally.
3. Verifies information on referral is accurate and complete.
4. Obtain precertification through private insurance if applicable.
5. Notifies patients if a copayment is required for outside services.
6. Verifies enrollment of patients to Cooper Green.
7. Verifies insurance benefits.
8. Answers phone & take complete, accurate messages. Makes sure messages are routed to appropriate person in a timely manner.
9. Accurately schedules patient appointment with appropriate information and accuracy.
10. May perform additional duties as assigned by Authorization Supervisor.
11. Assist with reporting as needed.
12. Obtain appointment date/time for patients referred outside of CGMHSA.
13. Ensure that information entered into Nextgen is complete and accurate.

Position Requirements:
Position requires a high school diploma or equivalent. College degree or relevant coursework may substitute for part of experience requirement. Familiar with medical terminology preferred. Professional telephone courtesy is a must. Candidates must have at least one year working in a medical practice setting. This position is responsible for ensuring that referrals are handled effectively and in a timely manner.

Must: (1) Attend all required course work assigned by management; (2) possess basic knowledge of medical terminology and advanced knowledge of PC applications, software, and database management; (3) possess exceptional telephone & customer service skills; and (4) be knowledgeable of English grammar & punctuation.

Cooper Green Mercy Health Services Authority is proud to be an AA/EOE/M/F/Vet/Disabled employer.




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